Lung Cancer in Women - Features, Differences and Treatment

How Does Lung Cancer Differ in Women?

Lung cancer is no longer considered a men’s disease. It is also a leading cause of cancer deaths in women. However, it differs between women and men in presentation, causes, treatment response, survival and symptoms. Let us examine its features in women.

Statistics

• Among cancers affecting women, lung cancer causes the most deaths.
• Worldwide each year, lung cancer causes more deaths in women than breast, uterine and ovarian cancers combined.
• Smoking is also the most important cause of lung cancer in women.
• Women who have never smoked account for %20 of women with lung cancer.

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Data show that men and women have equal risks of developing lung cancer.

Causes of Lung Cancer in Women

• Smoking
• Genetic factors
• Radon; radioactive gases
• Environmental factors
• Human Papillomavirus (HPV)

Comparing Lung Cancer in Women and Men

Men are more prone to squamous cell lung cancer, a form of non-small cell lung cancer, whereas adenocarcinoma is the most common type in women. Bronchioloalveolar carcinoma is a reclassified form of lung adenocarcinoma and is more common in women. For reasons not fully understood, its frequency is increasing slightly worldwide, particularly in young women who do not smoke.

Lung Cancer Symptoms in Women

• Persistent cough
• Coughing up blood
• Fatigue symptoms
• Shortness of breath
• Chest-back pain

Related Topic: Lung cancer symptoms (Detailed)

The Effect of Estrogen

Estrogen’s role in lung cancer is unclear. Women whose ovaries are removed before menopause may have increased lung cancer risk. Some studies suggest postmenopausal estrogen and progesterone therapy may increase lung cancer mortality, while birth control pills and hormone replacement therapy are thought to reduce lung cancer risk.

Lung Cancer Treatments in Women

Since 2010, lung cancer has been among the cancers with the largest increases in treatment options. Many treatments are now used sequentially or in combination.

Local Treatments: In early-stage lung cancer, surgery or radiation such as SBRT targets cancer cells locally for removal or destruction.

Systemic Treatments: Chemotherapy, targeted therapy and immunotherapy target cancer in the lungs or anywhere in the body, including sites of spread.

Surgery: Lung cancer surgery may be an option for tumors from stage 1 to stage 3A.

Radiotherapy: Radiotherapy may be chosen for several reasons. In early-stage lung cancer, stereotactic body radiotherapy (SBRT) may help achieve recovery. It is commonly given after surgery to eliminate remaining cancer cells (adjuvant treatment). Before surgery, it can be combined with chemotherapy to shrink tumors to an operable size (neoadjuvant treatment). It may also be used palliatively to improve disease symptoms.

Chemotherapy: Some studies suggest women respond to chemotherapy earlier and better than men. Chemotherapy can be used in both small cell and non-small cell lung cancer.

Targeted Therapies, Targeted Drugs: Genetic testing first looks for mutations that may drive lung cancer, such as EFGR, ALK, ROS1 and BRAF. These tests have become standard in stage 4 lung cancer. Such mutations are thought to cause approximately %30-40 of all non-small cell lung cancers. If a targetable mutation is found, targeted drugs are given as systemic treatment. More driver mutations are known in women’s lung cancers than men’s. Testing must not be overlooked, particularly in women without a smoking history.

Immunotherapy: This approach entered cancer treatment after 2012. Unlike chemotherapy, cancer immunotherapy does not directly kill cancer cells but stimulates the immune system to fight cancer. In this category, 3 drugs—nivolumab, pembrolizumab and atezolizumab—have been approved for lung cancer since 2015.

Clinical Trials: As in many cancers, we recommend suitable clinical trials for lung cancer patients when available. Participation both advances lung cancer research and offers free access to new treatments.

Lung Cancer Survival

Although dependent on disease stage and general condition, lung cancer survival rates are generally higher in women than men.

Awareness

Information from the internet, people around you or television may not provide reliable knowledge about lung cancer in women; little information is available. Find appropriate sources, review clinical trials and learn about treatments. You need not do this alone: meeting other women who have survived lung cancer treatment can let you benefit from their experiences.

What Can Women Do to Reduce Lung Cancer Risk?

Some steps women can take include:

• Quit if you smoke
• Avoid environments where people smoke
• Test your home for radon 
• Exercise and be physically active
• Eat healthily

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